Do you know about all our body shaping options?

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* 3. If you would like us to update your e-mail address on our client database, please fill in your current email address below?

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* 4. Are you self-conscious about your body shape & size?

Yes

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* 5. Are you currently overweight?

Yes

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* 6. If you answered yes to the previous question, how long have you been overweight for?

Less than 6 months

More than 6 months

More than 1 year

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* 7. Are you at a normal weight according to your BMI, but you have excess fat?

Yes

What is BMI? Please, tell me more.

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* 8. How much weight in kg do you need to lose?

0-5

6-10

11-20

20+

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* 9. Do you want to lose fat in certain areas of your body or for general weight loss?

General weight loss

Lose fat in certain areas of your body

Please specify:

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* 10. What motivates you most to follow your eating plan and lose weight?

Looking good

Being healthy

Feeling good about yourself

For medical reasons

Other (please specify)

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* 11. At what time of the year do you feel more determined to get your body into shape?

Beginning of the year

End of the year

Never feel determined to work on my body

Constantly on a eating program and exercise regime

Only before the holidays

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* 12. Have you tried our Body Renewal Medical Weight Loss program yet?

Yes

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* 13. What is your body shape?

Rectangle Body Shape

Hourglass body shape

Apple body shape

Pear body shape

Inverted triangle body shape

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* 14. Have you ever had any body shaping treatments at Renewal Institute?

Yes

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* 15. Which of the following treatment(s) have you had for body shaping?

Carboxytherapy

Radiofrequency (VelaShape, Titania, Exilis Elite)

Cryolipo Fat Freezing

Body lifting with PDO threads

i-lipo

Topical products

Other

If Other (please specify)

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* 16. Were you satisfied with the results of your body shaping treatments?

Yes

Not what I expected

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* 17. Are you comfortable in your swimwear, or do you always cover yourself?

I am comfortable in swimwear

I don't like being without full clothing

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* 18. Would you like a Renewal Institute staff member to contact you to discuss the survey and schedule an appointment?

Yes

Do you know about all our body shaping options? - September 2017

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* 1. What is your Name and Surname?

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* 2. Which Renewal Institute branch do you visit most often?

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* 3. If you would like us to update your e-mail address on our client database, please fill in your current email address below?

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* 4. Are you self-conscious about your body shape & size?

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* 5. Are you currently overweight?

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* 6. If you answered yes to the previous question, how long have you been overweight for?

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* 7. Are you at a normal weight according to your BMI, but you have excess fat?

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* 8. How much weight in kg do you need to lose?

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* 9. Do you want to lose fat in certain areas of your body or for general weight loss?

Question Title

* 10. What motivates you most to follow your eating plan and lose weight?

Question Title

* 11. At what time of the year do you feel more determined to get your body into shape?

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* 12. Have you tried our Body Renewal Medical Weight Loss program yet?

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* 13. What is your body shape?

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* 14. Have you ever had any body shaping treatments at Renewal Institute?

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* 15. Which of the following treatment(s) have you had for body shaping?

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* 16. Were you satisfied with the results of your body shaping treatments?

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* 17. Are you comfortable in your swimwear, or do you always cover yourself?

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* 18. Would you like a Renewal Institute staff member to contact you to discuss the survey and schedule an appointment?